The Effects of Training on Inhaler Technique and Quality Of Life in Patients with COPD

Göriş, Songül; Taşçı, Sultan; Elmalı, Ferhan

doi:10.1089/jamp.2012.1017

Cited by 59 publications

(61 citation statements)

References 31 publications

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“…Physical demonstrations were most common, whereas video demonstrations were used in six studies. 21, 25, 30, 31, 40, 51 The form of the demonstration did not have a significant effect on improvement of inhaler technique over baseline ( p > 0.05). Whether or not patients were requested to demonstrate own inhaler use after demonstration was frequently not reported.…”

Section: Resultsmentioning

confidence: 86%

Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

Klijn

Hiligsmann

Evers

et al. 2017

npj Prim Care Resp Med

107

116

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With the current wealth of new inhalers available and insurance policy driven inhaler switching, the need for insights in optimal education on inhaler use is more evident than ever. We aimed to systematically review educational inhalation technique interventions, to assess their overall effectiveness, and identify main drivers of success. Medline, Embase and CINAHL databases were searched for randomised controlled trials on educational inhalation technique interventions. Inclusion eligibility, quality appraisal (Cochrane’s risk of bias tool) and data extraction were performed by two independent reviewers. Regression analyses were performed to identify characteristics contributing to inhaler technique improvement. Thirty-seven of the 39 interventions included (95%) indicated statistically significant improvement of inhaler technique. However, average follow-up time was relatively short (5 months), 28% lacked clinical relevant endpoints and all lacked cost-effectiveness estimates. Poor initial technique, number of inhalation procedure steps, setting (outpatient clinics performing best), and time elapsed since intervention (all, p < 0.05), were shown to have an impact on effectiveness of the intervention, explaining up to 91% of the effectiveness variation. Other factors, such as disease (asthma vs. chronic obstructive pulmonary disease), education group size (individual vs. group training) and inhaler type (dry powder inhalers vs. pressurised metered dose inhalers) did not play a significant role. Notably, there was a trend (p = 0.06) towards interventions in adults being more effective than those in children and the intervention effect seemed to wane over time. In conclusion, educational interventions to improve inhaler technique are effective on the short-term. Periodical intervention reinforcement and longer follow-up studies, including clinical relevant endpoints and cost-effectiveness, are recommended.

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Section: Resultsmentioning

confidence: 86%

Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

Klijn

Hiligsmann

Evers

et al. 2017

npj Prim Care Resp Med

107

116

View full text Add to dashboard Cite

show abstract

“…Successful device training reduces the frequency of exacerbations and dyspnea and improves quality of life 42. Repeated instruction in inhalation techniques increases adherence and improves patients’ health status43 because patients are likely to forget what has been taught as time elapses from the point of training 12…”

Section: Discussionmentioning

confidence: 99%

Confidence in correct inhaler technique and its association with treatment adherence and health status among US patients with chronic obstructive pulmonary disease

Amin¹,

Ganapathy²,

Roughley³

et al. 2017

PPA

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BackgroundImproper use of bronchodilators is associated with poor disease control, nonadherence to long-term therapy, and poor clinical outcomes. Our current understanding of factors associated with correct inhaler use and adherence is limited. We measured physician-and patient-reported confidence in device usage and associations with treatment adherence and COPD-related health status.MethodsThis was an analysis of a US observational, point-in-time survey of physicians and patients. Physicians who met study eligibility criteria completed surveys for 5 consecutive, eligible patients who were then invited to respond to questionnaires. We assessed patient demographics, type of prescribed inhaler device(s), device training, COPD severity, comorbidities, physician-and patient self-reported confidence in device usage, treatment adherence, and health status.ResultsCompleted questionnaires for 373 patients were provided by 134 physicians. Complete confidence in device usage was observed for 22% and 17% of patients as reported by patients and physicians, respectively. Greater confidence was associated with higher self-reported adherence to inhaler usage. Physicians were more likely than patients to report lower levels of patient confidence in device usage. High physician- and patient-reported confidence were associated with more favorable health status. Predictors of confidence in device usage included fewer comorbidities, no depression, and higher education levels.ConclusionLow confidence in inhaler usage was associated with lower adherence and poor COPD-related health status. Choice of inhaler device tailored to patients’ ability to use specific devices and ongoing education to support optimal inhaler usage may improve patient confidence and enhance both adherence and health status.

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“…9 Growing evidence shows that educating and reviewing the technique with the patients have a positive impact on adherence, quality of life and control of asthma and COPD. [10][11][12] Several international organizations reinforce the need for clinicians to master knowledge about different types of inhalers available in the market and appropriate inhalation techniques for each one, in order to assess at each patient if the technique is appropriate to his particular profile. 13 The Portuguese Directorate General for Health recommends, in its standard clinical guideline for control of asthma, that the inhaler technique should be reviewed by health professionals at each visit with the patient.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Inhalation Technique in Clinical and Functional Control of Asthma and Chronic Obstructive Pulmonary Disease

et al. 2015

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Acta Med Port 2015 Nov-Dec;28(6):702-707 RESUMOIntrodução: A doença pulmonar obstrutiva crónica e a asma afectam quase 300 milhões de indivíduos em todo o mundo. A terapêutica inalatória associa-se frequentemente a erros na técnica realizada reduzindo a eficácia e adesão. Objectivo: Avaliar a técnica inalatória e sua relação com o controlo clínico e funcional em asma e doença pulmonar obstrutiva crónica. Material e Métodos: Estudo transversal analítico incluindo doentes com asma e doença pulmonar obstrutiva crónica medicados com dispositivos inalatórios. Recolheram-se dados demográficos e existência de ensino prévio da técnica. Avaliou-se a técnica inalatória em: Passo 1 -expiração prévia; Passo 2 -activação do dispositivo; Passo 3 -inspiração; Passo Step 1 -device activation;Step 2 -previous expiration;Step 3 -inspiration;Step 4 -end inspiratory pause. Teaching inhalation technique has a positive impact on its future performance. Most patients make mistakes, affecting clinical control in asthma, although in chronic obstructive pulmonary isease no relation was found. This is an ongoing work that aims to reevaluate inhalation technique after patients' education and its further impact.

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The Effects of Training on Inhaler Technique and Quality Of Life in Patients with COPD

Abstract: Consequently, a planned inhaler training given to the patients with COPD was found to decrease attack frequency and dyspnea, and improve quality of life.

Cited by 59 publications

References 31 publications

Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review

Confidence in correct inhaler technique and its association with treatment adherence and health status among US patients with chronic obstructive pulmonary disease

Assessment of Inhalation Technique in Clinical and Functional Control of Asthma and Chronic Obstructive Pulmonary Disease

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